[Surgical complications of colostomies]

The colostomy may be terminal or lateral, temporary or permanent. It may have psychological, medical or surgical complications. Aim: reporting the incidence of surgical complications of colostomies, their therapeutic management and trying to identify risk factors for their occurrence.A retrospective study for a period of 5 years in general surgery department, Habib Bourguiba hospital, Sfax, including all patients operated with confection of a colostomy. Were then studied patients reoperated for stoma complication. Among the 268 patients who have had a colostomy, 19 patients [7%] developed surgical stoma complications. They had a mean age of 59 years, a sex ratio of 5.3 and a 1-ASA score in 42% of cases. It was a prolapse in 9 cases [reconfection of the colostomy: 6 cases, restoration of digestive continuity: 3 cases], a necrosis in 5 cases [reconfection of the colostomy], a plicature in 2 cases [reconfection of the colostomy] a peristomal abscess in 2 cases [reconfection of the colostomy: 1 case, restoration of digestive continuity: 1 case] and a strangulated parastomal hernia in 1 case [herniorrhaphy]. The elective incision and the perineal disease were risk factors for the occurrence of prolapse stomial. Surgical complications of colostomies remain a rare event. Prolapse is the most common complication, and it is mainly related to elective approach. Reoperation is often required especially in cases of early complications, with usually uneventful postoperative course

Liver cystic echinococcosis: which cysts are correlated with false negative indirect passive hemagglutination [IHA]?

It's generally agreed that calcified liver cystic Echinococcosis [CE] is associated with negative serology; the influence of other cystic features on serologie result remains unclear. The aim of this study is to determine predictive factors of negative indirect passive hemagglutination [IHA] in liver CE. 119 patients operated on for liver CE, had preoperative IHA. Correlation was studied between serological result and sex, age of patient and number [single vs multiple], size, ultrasonic type [uni-locular, multivesicular, degenerative] and intrabiliary rupture of cyst. IHA sensitivity was 74.8%. Univaried analysis showed that false negative serology was correlated with age < 10 or > 20 years [p< 0.01], single cyst [p< 0.006], cystic size < 9 cm [p< 0.03] and unilocular or degenerative cyst in comparison with multivesicular type [p< 0.01 and p< 0.03 respectively]. in liver CE, cystic predictive factors of false negative IHA are single cyst, unilocular or degenerative type and size inferior to 9 cm

[Laparoscopic repair of a post-traumatic ruptured diaphragm: case report]

We report an observation of traumatic rupture of the diaphragm repaired laparoscopically. A 23-year-old man was admitted to our hospital two days after having undergone a traffic accident. The diagnosis was evoked by chest radiograph, then confirmed by Computed tomography scan, in front of an ascension of the left diaphragmatic cupola and an intra-thoracic digestive clarity. Seen the hemodynamic stability of the patient, a laparoscopic repair was indicated. The intra-abdominal pressure was fixed at 10 mm Hg. Despite the retraction of the diaphragmatic banks and the posterior seat of the breach, the intervention was held without any major incident. The postoperative course was marked by the formation of an encysted left pleural hematoma evacuated by a lung decortication. The evolution was normal thereafter